dc.contributor.author | Inyangala, Sylvano K | |
dc.date.accessioned | 2021-01-28T06:37:42Z | |
dc.date.available | 2021-01-28T06:37:42Z | |
dc.date.issued | 2020 | |
dc.identifier.uri | http://erepository.uonbi.ac.ke/handle/11295/154354 | |
dc.description.abstract | Background: Dyslipidemia is markedly common in type 2 Diabetes Mellitus patients and
one of the modifiable risk factors for cardiovascular disease, which is responsible for the
increased burden of disease and mortality in diabetic patients. The use of lipid-lowering
agents and lifestyle modification remains a fundamental approach in controlling diabetic
dyslipidemia. However, suboptimal treatment of lipid abnormalities and underutilization
of lipid-lowering agents in high-risk individuals, including patients with T2DM, remains a
common challenge in clinical practice. There is inadequate information on the level of
control of lipids profile and the determinants among patients with T2DM, especially in low
and middle-income countries in Africa, including Kenya.
Broad Objective: The study aimed at evaluating the patterns and determinants of
dyslipidemias among patients with type 2 Diabetes mellitus in a tertiary level facility in
Kenya.
Methodology: A hospital-based cross-sectional survey was done. A total of 235
participants aged between 40-75 years old with T2DM were randomly selected. A
researcher administered a questionnaire, and abstraction forms were used to collect the
data. STATA Version 13 was used to analyze the data. Both descriptive and inferential
statistics used to summarize the study results and deduce inferences between the dependent
and explanatory variables. Bivariate and multivariate logistic regression models were
applied to establish the association between the outcome variable and independent
variables with the level of significance set at p≤0.05.
Results: A total of 235 T2DM participants were involved, of which the majority were
female, 60.4%. The median age of participants was 60 (52-67) and hypertension was the
prevalent comorbidity (60.9%). Statins were the only lipid-lowering agents prescribed
63.8%, with most participants prescribed moderate atorvastatin intensity (57.4%). Lifestyle
modification strategies indicated for lipid modification included dietary change (69.2%),
moderate physical exercise (58.5%), and control of social habits such as smoking and
excessive alcohol intake. Isolated dyslipidemia with elevated LDL-c was the most
prevalent dyslipidemia pattern followed combined elevated TG and LDL-c.
Adherent to lipid-lowering agents was observed in only 48% of the participants. The
proportion of participants with optimal LDL-C control (<2.6 mmol/l, TG (<1.7 mmol/l),
HDL >1.04 mmol/l(male) and >1.30 mmol/l( female) and non HDL-C < 3.37 mmol/L was
50.2%, 17%, 88.2% and 72.3%, respectively. Adherent to lipid lowering and the use of
lipid-lowering agents (statins) was significantly associated with LDL-c target control
(AOR 2.0; CI 1.16-3.47; p=0.013), and (aOR 2.2;CI 1.26-4.03 ;p=0.006). Predictors for
optimal non-HDL-C control include; higher level education (aOR 2.2.;CI-1.00-
4.87:p=0.04), lipid lowering agent use( aOR 2.0;CI 1.01-3.88:p=0.024) and hypertension
(aOR 2.0;CI 1.04-3.67 : p=0.036).
Conclusion: The control of dyslipidemia among T2DM patients attending the outpatient
clinic at KNH is still inadequate because of the underutilization of lipid-lowering agents
and patients’ non-adherence to lipid-lowering therapy.
Recommendations: The utilization of lipid-lowering drugs among T2DM patients should
be enhanced. This can be achieved through sensitizing both the prescribers and patients. | en_US |
dc.language.iso | en | en_US |
dc.publisher | University of Nairobi | en_US |
dc.rights | Attribution-NonCommercial-NoDerivs 3.0 United States | * |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/3.0/us/ | * |
dc.subject | Patterns and determinants of dyslipidemias among patients with type 2 diabetes mellitus at Kenyatta National Hospital. | en_US |
dc.title | Patterns and determinants of dyslipidemias among patients with type 2 diabetes mellitus at Kenyatta National Hospital. | en_US |
dc.type | Thesis | en_US |
dc.description.department | a
Department of Psychiatry, University of Nairobi, ; bDepartment of Mental Health, School of Medicine,
Moi University, Eldoret, Kenya | |